| Kanoknuch Shiflett Dental Corp | |
|
906 S Sunset Ave Ste 105 West Covina CA 91790-3400 | |
| (626) 480-1543 | |
| (626) 480-0622 |
| Full Name | Kanoknuch Shiflett Dental Corp |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 906 S Sunset Ave Ste 105, West Covina, California |
| Authorized Official Name and Position | Kanoknuch Shiflett (CEO) |
| Authorized Official Contact | 6269913544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kanoknuch Shiflett Dental Corp 906 S Sunset Ave Ste 105 West Covina CA 91790-3400 Ph: (626) 480-1543 | Kanoknuch Shiflett Dental Corp 906 S Sunset Ave Ste 105 West Covina CA 91790-3400 Ph: (626) 480-1543 |
| NPI Number | 1295215168 |
|---|---|
| Provider Enumeration Date | 08/20/2018 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295215168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 40303 (California) | Primary |
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